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Review
. 2013 Sep;25(5):487-94.
doi: 10.1097/01.cco.0000432525.70099.a4.

Pathology of lymphoma in HIV

Ethel Cesarman  1
Affiliations
Review

Pathology of lymphoma in HIV

Ethel Cesarman. Curr Opin Oncol. 2013 Sep.

Abstract

Purpose of review: HIV-infected individuals have a greatly increased risk of developing malignancies, even when HIV infection is successfully controlled with antiretrovirals. Non-Hodgkin's lymphoma is considered an AIDS-defining entity, and this disease is currently the most common type of cancer in HIV-infected individuals in the USA and Europe. Here, we describe the different types of lymphomas occurring in individuals with AIDS, and the most relevant pathologic features helpful for histologic and immunohistochemical diagnosis.

Recent findings: The incidence of some AIDS-related lymphoma subtypes has changed since the introduction of combined antiretroviral therapy, and some of the diagnostic methodologies have evolved. New biomarkers of disease have been identified, which may be useful for diagnosis.

Summary: Better pathological classification strategies and deeper molecular understanding of the different lymphoma subtypes that occur in people with AIDS will begin to allow the transition to more precise diagnosis and targeted treatments.

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Figures

Figure 1
Figure 1. Distribution and EBV status of AIDS related lymphomas. Tumor Characterization
A) Distribution of tumor type among 72 AIDS-related lymphoma specimens is shown. Cases included DLBCL of the GCB (n=24) and non-GCB (n=18) subtypes, Burkitt lymphoma (n=12), plasmablastic lymphoma (n=5), BCL, U (n=4), and polymorphic lymphoproliferative disease (LPD) (n=1). Proportion of EBV positivity is shown as determined by EBV encoded RNA (EBER) in situ hybridization. B) EBV status is most commonly determined by EBER in situ hybridization. A negative case is shown on the left and a positive one is shown on the right. Original magnification: 40X.
Figure 2
Figure 2. Subclassification of AIDS-related DLBCL into differentiation subtypes
Cases can be sub-classified using immunohistochemistry according to the algorithm reported by Hans et al. as in non-AIDS related DLBCL as shown in the diagram (18). Left panel shows the histology (hematoxilin and eosin) and immunophenotype of a representative case of AIDS-related DLBCL with a GC phenotype: CD10+, BCL-6+, MUM-1–, and the right panel shows a case of AIDS-related DLBCL with a non-GC phenotype: CD10­–, BCL-6–, MUM-1+. The original magnification for hematoxillin and eosin was 132X and for the immunohistochemistry pictures 66X. Adapted with permission from (13).
Figure 3
Figure 3. AIDS related Burkitt’s lymphoma
The left panel shows the histology (hematoxilin and eosin) of a case of Burkitt’s lymphoma, with fairly monotonous medium sized cells, mitotic figures (black arrows) and a starry-sky pattern due to numerous tangible body macrophages (white arrows). Original magnification: 400X. The diagnostic immunophenotype of BL is listed.
See this image and copyright information in PMC

References

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